I recently came across this article by Jacob Sullum. (I am presently trying to get permission to reprint the whole thing in my offline version.) Mr. Sullum's point, with which I agree, is that many of our modern "public health" problems are, in reality, merely the source of duplicitous methods of incrementally snatching away our freedoms, one bit at a time. Discussing video games, gambling, and smoking, he says:
Calling the habits that supposedly lead to these consequences “public health” problems, “epidemics” that need to be controlled, equates choices with diseases,He quotes John Stuart Mill:
disguises moralizing as science, and casts meddling as medicine. It elevates a collectivist calculus of social welfare above the interests of individuals, who become subject to increasingly intrusive interventions aimed at making them as healthy as they can be, without regard to their own preferences.
“The sole end for which mankind are warranted, individually or collectively, in interfering with the liberty of action of any of their number is self-protection.…The only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others. His own good, either physical or moral, is not a sufficient warrant.” Mill’s “harming principle” is obviously important to libertarians, but public health practitioners also should keep it in mind if they do not want to be seen as moralistic busybodies constantly seeking to expand the reach of government.He discusses proposals to tax high fat foods as doomed to failure. He goes on:
But I can think of a couple of policies that would make a difference. Instead of a “junk food” tax, which is inefficient and unfair because it is paid by the thin as well as the fat, why not tax people for every pound over their ideal weight? People would be required to get weighed once a year at an approved station, which would send its report to the Internal Revenue Service. If the tax were set high enough, I’m sure many people would lose weight. If that seems too complicated, how about mandatory calisthenics in the town square every morning? Assuming these policies are feasible and cost-effective, is there any basis for objecting to them “from a public health perspective”?It's all really about freedom.
If not, I’d suggest that the public health perspective leaves out some important considerations. Maximizing health is not the same as maximizing happiness. The public health mission to minimize morbidity and mortality leaves no room for the possibility that someone might accept a shorter life span, or an increased risk of disease or injury, in exchange for more pleasure or less discomfort. Motorcyclists, rock climbers, and sky divers make that sort of decision all the time, and not all of them are ignorant of the relevant injury and fatality statistics. With lifestyle choices that pose longer-term risks, such as smoking and overeating, the dangers may be easier to ignore, but it is still possible for someone with a certain set of tastes and preferences to say, “Let me enjoy myself now; I’ll take my chances.” The assumption that such tradeoffs are unacceptable is the unspoken moral premise of public health. When the surgeon general declares that “every American needs to eat healthy food in healthy portions and be physically active every day,” where does that leave a guy who prefers to be fat if it means he can eat what he likes and relax in his spare time instead of looking for ways to burn calories?
It’s true that, as the anti-smoking activist William Cahan pointed out on a CNN talk show several years ago, “People who are making decisions for themselves don’t always come up with the right answer.” They don’t necessarily make tradeoffs between health and other values in an informed or carefully considered manner. Sometimes they regret their decisions. But they know their own tastes and preferences, and they have access to myriad pieces of local information about the relevant costs and benefits that no government regulator can possibly know. They will not always make good decisions, but on balance they will make better decisions, as measured by their own subsequent evaluations, than any third party deciding for them. Leaving aside the question of who is better positioned to decide whether a given pleasure is worth the risk associated with it, there is an inherent value to freedom: When it comes to how people feel about their lives, they may well prefer to make their own bad choices rather than have better ones imposed on them.
His piece is long by blog standards, but well worth reading.